[Analysis of healthy life expectancy and related socioeconomic influencing factors among the middle-aged and elderly in China, the United States, and the European Union]

Objective: To calculate and compare the healthy life expectancy (HLE) of the middle-aged and elderly in China, the United States, and developing and developed countries in the European Union(EU) and analyze the impact of socioeconomic factors on HLE in different countries or regions. Methods: Four surveys from 2010 to 2019 were brought into the research. The data were collected from the China Health and Retirement Longitudinal Study, Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe. Developed and developing countries in the EU were divided into two groups for calculation. Education level, total family wealth, and work retirement status were selected to measure socioeconomic status, and activities of daily living were used as health status indicators. We used the multi-state life cycle table method to calculate the transition probability between different health states and estimate life expectancy and HLE. Results: A total of 69 544 samples were included in the study. In terms of age, the middle-aged and elderly in the United States and developed countries of the EU have higher HLE in all age groups. In terms of gender, only Chinese women have lower HLE than men. Regarding socioeconomic factors, the middle-aged and elderly with higher education levels and total family wealth level have higher HLE. In China, working seniors have higher HLE, while for USA women and developed countries of the EU, retired or unemployed seniors have higher HLE. Conclusions: Demographic and socioeconomic factors impact HLE in different countries or regions. China should pay more attention to the health of women and the middle-aged and elderly retired with lower education and less total family wealth.

[Reliability and validity of Stanford Presenteeism Scale (SPS-6) in Chinese occupational population]

Objective: To investigate the reliability and validity of Stanford attendance scale (sps-6) in the study of attendance among professional groups. Methods: In August, 2018, the 1455 employees from 81 workplaces in Beijing, Shanghai, Jiangsu and Guangdong were randomly investigated as the subjects. The reliability and validity of sps-6 were analyzed by using the internal consistency reliability (Cronbach's coefficient) , half split half coefficient, content validity, integration validity, discrimination validity, cluster analysis and structural validity analysis. Results: Cronbach's coefficients of sps-6 scale, working process and work results were 0.692, 0.918 and 0.907, respectively; Guttman of scales and dimensions The split half coefficients were 0.792, 0.803 and 0.794, respectively; Pearson correlation coefficients of the total score of each item and scale were 0.526-0.673 (P<0.01) ; the qualification rate of set validity and differentiation validity were 100%; the results of cluster analysis supported the theoretical basis for the formation of the scale. The general non-standard fitting index (TLI) =0.982, approximate error mean square root mean square (RMSEA) =0.071, comparative fit index (CFI) =0.990, fit goodness index (GFI) =0.987, modified fit goodness index (AGFI) =0.965, Norm fit index (NFI) =0.990. The results showed that the scale had higher structural validity, and the results of sps-6 in the occupational population were (21.36±4.04) , and the distribution was normal (deviation was 0.053, peak was 0.023) . The scores of sps-6 scale were statistically different in various charactoristics of gender, age, education level, marital status, annual income, position, position level and industry (P< 0.01) . Conclusion: Stanford attendance scale has high reliability and validity, and can be applied to the study of attendance in professional groups.

[Research on equity and influencing factors of disability among Chinese middle-aged and old people]

OBJECTIVE

To evaluate disability status and equity of the middle-aged and old population in China, and to explore the influencing factors contributing to the inequity of disability.

METHODS

This study was based on data collected from the first wave survey (2007-2010) of World Health Organization Study on Global Ageing and Adult Health (SAGE). Concentration index (CI) and concentration curve were calculated to measure the economic-related inequity of disability among the Chinese middle-aged and old people. The CI was further decomposed in which the attributions of social and individual determinants were calculated.

RESULTS

The mean score of the World Health Organization Disability Assessment Sche-dule (WHODAS) was 7.32 among the Chinese middle-aged and old people, 6.37 for males and 8.21 for females. The CI for the whole participants was -0.190 9, compared with -0.184 4 for the middle-aged and old men and -0.196 1 for the women. After decomposition of the CI, socioeconomic status contributed most to disability inequity among the Chinese middle-aged and old population. Financial status, educational level and work type contributed 66.41%, 16.45% and 13.10% respectively to inequity of disability. Individual lifestyle factors, including tobacco use, alcohol consumption and physical activities, contributed less to inequity of disability compared with social structural determinants.

CONCLUSION

There was inequity of disability among Chinese middle-aged and old population, and those with better financial status were less likely to suffer from functional disability. Middle-aged and old males were less disabled than females, and had less inequity of disability. Financial status, educational level and work type took the highest contribution to inequity of disability among Chinese middle-aged and old population, suggesting that promoting healthy lifestyles alone cannot effectively reduce the inequity of disability. The government needs to continually strengthen and improve appropriate social and medical protection measures on the basis of the importance it attaches to the health of the middle-aged and old population, and makes reducing health inequities a policy priority. The government should pay attention to the provision of healthcare and other resources in areas where development is relatively lagging and where there is a relative concentration of middle-aged and old population. Meanwhile, there should be more significant support for research on health status and equity among the middle-aged and old population to obtain more evidence for proactive responses to rapid population aging in China and policy development.

[COVID-19 pandemic: global epidemiological trends and China's subsequent preparedness and responses]

The outbreak of COVID-19 has spread quickly across 114 countries/territories/areas in six continents worldwide and has been announced as a pandemic by WHO. This study analyzed global COVID-19 epidemiological trends, examined impact of the pandemic on global health security, diplomacy, and social environment in China, and provided short- and long-term strategic policy recommendations for China's subsequent preparedness and responses.

[Clinical effect of bi-layered artificial dermis and autologous skin graft in repairing bone and/or tendon exposed wounds]

Objective: To explore the clinical effect of bi-layered artificial dermis combined with autologous skin graft in the repair of wounds with exposed bone and/or tendon. Methods: The medical records of 25 patients (aged 3 to 79 years, including 21 males and 4 females) with bone and/or tendon exposed wounds caused by various reasons, admitted to Nanfang Hospital of Southern Medical University from May 2014 to December 2018 were analyzed retrospectively. Of the 25 patients, 7 patients had exposed bone only, 13 patients had exposed tendon only, and 5 patients had exposure of both bone and tendon. The total wound area was 78.0 (53.4, 103.2) cm(2). The widths of bone exposure and tendon exposure were 3.2 (3.0, 3.6) cm and 2.0 (1.7, 2.4) cm, respectively. All wounds were implanted with bi-layered artificial dermis in the first stage after thorough wound debridement. After 2 to 3 weeks of vascularization of artificial dermis, autologous thin-to-medium-thickness skins or split-thickness skins were grafted to repair the wounds in the second stage. The vascularization of artificial dermis and its time, whether or not producing hematoma, the skin graft survival rate on day 7 post autologous skin grafting, whether or not repeating skin grafting, and the time of complete wound healing were observed and recorded. The patients were further followed up and observed for 3 or more months after discharge. Results: The vascularization of artificial dermis was achieved in 24 patients after the first transplantation with vascularization time being 11-21 (16±4) days. No hematoma was observed in the transplanted artificial dermis. Failed vascularization of grafted artificial dermis was observed in one patient who was later treated with negative pressure drainage and skin grafting alone, and was discharged with wound healing. The skin graft survival rate on day 7 post autologous skin grafting was 92.2%-100.0% ( (99.3±1.3)%), with the remaining wound areas recovered later by themselves or healed by dressing changes without repeated skin grafting. The complete wound healing time was 7-19 (11.9±2.8) days after autologous skin grafting. The patients were followed up for 3 to 60 months after discharge. Except for the pigmentation in skin graft area, the skin grafts survived well, being soft in texture and with no repeated ulceration, obvious hypertrophic scar, or contracture deformity. Conclusions: Artificial dermis combined with autologous skin grafting can effectively repair wounds with bone and/or tendon exposure, providing a repair strategy for this type of wounds.

Highly expressed lncRNA FAL1 promotes the progression of gastric cancer by inhibiting PTEN

OBJECTIVE

The aim of this study was to investigate the function of FAL1 in gastric cancer (GC) development and to examine its underlying mechanism. Our study might provide a theoretical basis for developing novel diagnostic markers for GC.

PATIENTS AND METHODS

FAL1 expression in GC tissues and adjacent tissues was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The serum level of FAL1 in GC patients with different pathological grades was further detected. The effects of FAL1 on cell proliferation and cell cycle were detected by cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Meanwhile, Western blot was used to detect the protein expression of PTEN after FAL1 overexpression or knockdown in GC cells. In addition, rescue experiments were conducted to verify the regulatory effect of FAL1 on PTEN.

RESULTS

QRT-PCR results showed that the expression of FAL1 in GC tissues was remarkably higher than that of adjacent tissues. FAL1 expression was correlated with pathological grades of GC patients. Meanwhile, FAL1 overexpression promoted the proliferation and cell cycle of BGC-823 and MGC-803 cells. Western blot analysis demonstrated that FAL1 could inhibit the protein expression of PTEN in GC cells. In addition, rescue experiments indicated that the overexpression of PTEN could partially reverse the effect of FAL1 on the proliferation and cell cycle of BGC-823 and MGC-803 cells.

CONCLUSIONS

The overexpression of FAL1 can promote cell proliferation and cell cycle of GC via inhibiting PTEN.

[Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation with IBu Precondition Regimen in Treatment for 11 Patients with Low to Intermediate Risk Acute Myeloid Leukemia]

OBJECTIVE

To evaluate safety and efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) with IBu precondition regimen consisting of high-dose idarubicin (IDA) and busulphan (Bu) for treatment of patients with low and intermediate risk acute myeloid leuekmia (AML).

METHODS

A total of 11 patients with AML (5 low and 6 intermediate risk patients) treated with auto-PBHSCT with IBu precondition regimen (IDA 20 mg/m², continuous i.v. from d-13 to d-11, Bu 0.8 mg/kg/q6h i.v. for 2h, from d-5 to d-2) from March 2011 to July 2014 were analyzed retrospectively. Adverse effects and transplantation-related mortality (TRM) were evaluated. Kaplan-Meier analysis was performed to calculate the overall survival (OS), disease-free survival (DFS) and cumulative relapse rate (RR). Cox regression was performed for univariate analysis for DFS.

RESULTS

Among the 11 patients, 10 patients obtained hematopoietic reconstitution, 1 patient died during transplantation, thus the TRM was 9.1%. The adverse effects were well tolerated. With median follow-up of 31.6 (8.7-52.5) months, 7 patients (63.3%) were alive, including 6 patients (54.5%) in continuous complete remission (CR). Median OS and DFS were not reached. The 3-year OS, DFS and RR were (57.7±16.3)%, (52.5±17.6)% and 47.5%, respectively. Univartiate analysis indicated that the age, sex, interval between diagnosis and transplantation, white blood cell count at diagnosis, risk-grouping (low or intermediate risk), disease status before transplantation (CR1 or CR2), and count of mononuclear cells for infusion all can not influence DFS(P>0.05, respectively).

CONCLUSION

The treatment of auto-PBHSCT with IBu precondition regimen for low to intermediate risk AML patients is safe and effective.

Association between polymorphisms in the promoter region of pri-miR-34b/c and risk of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a major cause of cancer-related deaths worldwide. MicroRNA-34 (miR-34) gene plays a key role in altering the apoptotic cycle and pathways of downstream cells, and therefore influences carcinogenesis. In this case-control study, we assessed the role of the pri-miR-34b/c rs4938723 polymorphism in HCC risk. The pri-miR-34b/c polymorphic genotype was determined in 286 patients with HCC and 572 controls using polymerase chain reaction-restriction fragment length polymorphism. The male gender (X² = 12.95, P < 0.001), regular alcohol consumption (X² = 16.81, P < 0.001), and a family history of cancer (X² = 11.88, P = 0.001) were associated with HCC risk. However, the age (t = 1.19, P = 0.12) and tobacco smoking habit (X² = 0.64, P = 0.42) of HCC patients were comparable to those of the controls. The TC (adjusted OR = 1.46, 95%CI = 1.06-2.01) and CC (adjusted OR = 3.07, 95%CI = 1.77-5.34) genotypes of pri-miR-34b/c rs4938723 were correlated with a higher risk of HCC compared to the TT genotype. Moreover, the TC+CC genotype was correlated with an increased risk of HCC compared to the TT genotype (adjusted OR = 1.64, 95%CI = 1.21-2.22). In the recessive model, the CC genotype of pri-miR-34b/c rs4938723 was significantly correlated with an elevated risk of HCC compared to the TT+TC genotype (adjusted OR = 2.50, 95%CI = 1.49-4.22). Further large-scale and multi-center studies are required to confirm these results.

Association of TUSC3 gene polymorphisms with non-syndromic mental retardation based on nuclear families in the Qinba mountain area of China

TUSC3 interacts with the protein phosphatase 1 and magnesium ion transport system, which plays an important role in learning and memory. Abnormal conditions of learning and memory are common clinical characteristics of mental retardation (MR). However, the association of TUSC3 genetic polymorphisms with MR remains unknown. A total of 456 DNA samples including 174 nuclear families containing MR were collected in the Qinba mountain area of China. The genotypes of eight tag single nucleotide polymorphisms of TUSC3 were evaluated with traditional genetic methods. Family-based association tests, transmission disequilibrium tests (TDTs), and haplotype relative risk (HRR) analyses were performed to investigate the association between genetic variants of the TUSC3 gene and MR. The genetic polymorphisms rs10093881, rs6530893, and rs6994908 were associated with MR (all P values <0.05) based upon the results of single-site TDT and HRR analyses. The haplotype block consisting of rs6530893 and rs6994908, harboring the sixth exon of TUSC3, was also associated with MR (all P values <0.05). This study demonstrated an association between genetic polymorphisms of the TUSC3 gene and MR in the Qinba mountain area, the sixth exon of which might contribute to the risk of MR. However, further studies are needed on the causal mechanisms in this association.

[Drug resistance of extended-spectrum-β-lactamases-producing bacteria in children with hematological malignancy after chemotherapy]

OBJECTIVE

To study the prevalence and drug resistance of extended-spectrum-β-lactamases (ESBLs)-producing bacteria in blood culture isolated from children with hematological malignancy after chemotherapy.

METHODS

Blood samples taken from 3264 children with hematological malignancy and severe infection following chemotherapy between 2002 and 2008 were cultured using the Bact/ALTER 3D blood culture system. VITEK 60 automicroscan was used to identify viral species and to conduct drug resistance tests. The results were indentified according to National Committee for Clinical Laboratory Standard guidelines.

RESULTS

Fifty-eight strains of Escherichia coli and fifty-one strains of Klebsiella pneumoniae were isolated. Thirty-eight strains of Escherichia coli and nineteen strains of Klebsiella pneumoniae were ESBLs-producing and these ESBLs-producing strains were less susceptible than those that were non-ESBLs-producing to most antibiotics. Both ESBL- and non-ESBL-producing strains were susceptible to imipenem, piperacillin/tazobactam and amikacin.

CONCLUSIONS

The prevalence of ESBLs-producing bacteria is high in childrn with hematological malignancy and infection following chemotherapy. ESBLs-producing bacteria are resistant to common antibiotics, suggesting that antibiotic treatment based on the result of antimicrobial susceptibility test is necessary in these children.

Calponin expression in laryngeal myoepithelial carcinoma and its prognostic implications: a case report and literature review

A case report of laryngeal myoepithelial carcinoma (MEC) is presented and the literature concerning prognostic factors in MEC is reviewed. A 61-year old man was admitted to hospital with hoarseness and progressive dyspnoea. On examination, both vocal cords were fixed in the midline with a glottic fissure of only 3 mm. No tumour was seen, but the subglottis was not completely visible. A computed tomography scan showed a soft mass below the right vocal cord obstructing two-thirds of the larynx. On suspension laryngoscopy, a dull mass (1.5 x 1.5 cm) was seen below the right vocal cord, which was malignant on frozen biopsy. A total laryngectomy was performed and the patient received radiotherapy. He died of recurrence 25 months later. The tumour was positive for cytokeratin 14, S-100 protein and calponin. MEC of the larynx is extremely rare. The clinical behaviour of MEC is variable and prognostic factors have been poorly analysed. Calponin expression may be a prognostic factor, but other factors also affect the outcome in MEC.

Prognosis and Expression of Lambda Light Chains in Solitary Extramedullary Plasmacytoma of the Head and Neck: Two Case Reports and a Literature Review

Two cases of extramedullary plasmacytoma (EMP) of the head and neck, an uncommon plasma cell neoplasm, were studied. Both patients had good outcomes and have been followed for 17 and 12 years without recurrence or systemic disease. In these two cases, the tumours measured were 4 cm and 0.3 cm, and both cases were positive for lambda light chain restriction on immunohistochemistry. Prognostic factors were considered, based on a review of EMP of the head and neck, including published reports and the authors' clinical experience. Of all plasma cell tumours, EMP has the best prognosis, especially when located in the head and neck region. Variation in the biological behaviour of EMP and the limited number of documented cases make it difficult to determine prognostic factors. Some series have found that age, tumour size, site of origin (extramedullary versus bone), grade, M-protein, light chains and radiotherapy dose all influence the outcome in EMP patients.

Lack of association between the paraoxonase 1 Q/R192 single nucleotide polymorphism and stroke in a Chinese cohort

BACKGROUND

Serum paraoxonase (PON1) is an HDL-associated esterase that hydrolyzes products of lipid peroxidation and prevents the oxidation of LDL. Paraoxonase 1 (PON1) was implicated in susceptibility to stroke in previous studies. We investigated the correlation between the paraoxonase Gln-Arg 192 polymorphism (PON1Q/R192) and stroke including cerebral hemorrhage and cerebral infarction.

METHOD

The association between the paraoxonase Gln-Arg 192 polymorphism (PON1Q/R192) and stroke was investigated in 1019 subjects, which involved 305 cases with cerebral hemorrhage, 375 cases with cerebral infarction and 339 healthy controls.

RESULTS

The PON1Q/R192 genotype distribution in the cerebral hemorrhage group was QQ13.1%, QR48.2% and RR38.7% and in the cerebral infarction group was QQ13.6%, QR44.0% and RR42.4% respectively. There was no significant difference in PON1Q/R192 allele and genotype distribution between the patient group and the control group (P > 0.05). The PON1 polymorphism was not associated with cerebral hemorrhage or infarction.

CONCLUSION

Our study suggests that serum paraoxonase (PON1) is not associated with cerebral hemorrhage or infarction, although it is a lipolactonase which is associated with HDL-apolipoprotein A-I (HDL-apoA-I) and plays a role in the prevention of atherosclerosis.

Unfolding core asymmetries with x-ray emission images in symmetry diagnostic experiments

A novel inversion technique is proposed to unfold core asymmetries at the source with x-ray emission images, which were obtained from imploded surrogate capsules in symmetry diagnostic experiments. The axisymmetrical core emission can be expanded as a Fourier series, with Legendre polynomials and spherical Bessel functions as bases concerned with polar angle and radius, respectively. A least-squares estimator is employed to obtain the unknown coefficients from its two-dimensional image data. The unfolded Legendre coefficients can be further used to test modeling of drive asymmetries in hohlraums. This technique is also demonstrated with a proof-of-principle experiment performed on the Shenguang II laser facility [L. Zunqi et al., Chin. J. Lasers B10, 6 (2001)].

Thomson scattering measurements of heat flux from ion-acoustic waves in laser-produced aluminum plasmas

Thomson scattering (TS) measurements are performed at different locations in a laser-produced aluminum plasma. Variations of the separation, wavelength shift, and asymmetric distribution of the two ion-acoustic waves are investigated from their spectral-time-resolved TS images. Detailed information on the space-time evolution of the plasma parameters is obtained. Electron distribution and variation of the heat flux in the plasma are also obtained for a steep temperature gradient.

Double-peak emission of hot electrons generated by femtosecond laser interaction with solid targets

Double-peak emission of hot electrons has been observed in the interaction of a 60-fs, 125-mJ, 800-nm, p-polarized laser pulse with Al targets. One peak in the specular direction is due to the reflected laser light, which excites a plasma wave to accelerate electrons. The other peak, which is more consistent with theories of Phys. Plasmas 6, 2855 (1999)] and Phys. Rev. Lett 82, 743 (1999)], is produced by the resonance absorption at approximately 15 degrees from the target normal.

[Experimental study on effect of xinfeng capsule in treating rats' adjuvant arthritis on ultrastructure of synoviocyte and splenic lymphocyte]

OBJECTIVE

To observe the effect of Xinfeng capsule (XFC) on the ultrastructure of synoviocyte and splenic lymphocyte in rat adjuvant arthritis (AA) model.

METHODS

Sixty rats were randomly divided into normal control group, model group, XFC group and Tripterygium wilfordii polycoside (TP) group, 15 in each. Complete adjuvant 0.1 ml was injected into right posterior metatarsus of rats subcutaneously to induce inflammation, except that in the normal control. The ultrastructural change including mitochondria swelling, vacuolation and ridge pathologic change of synoviocyte and splenic lymphocyte was observed by transmission electron microscopy (TEM). The mitochondria lesion rate (MLR) of each group was then calculated.

RESULTS

The swelling degree of right posterior metatarsus in XFC and TP group obviously lowered after treatment (P < 0.05). MLR of synoviocyte in the XFC group and the TP group after treatment was also obviously lower than that in the model group (P < 0.05). MLR of splenic lymphocyte in the XFC group reduced markedly (P < 0.05) after treatment, while in the TP group, the change was insignificant (P > 0.05). In comparison with TP group, the reduction of both MLR of synoviocyte and splenic lymphocyte after treatment in the XFC group was more significant (P < 0.05).

CONCLUSION

XFC could lower the degree of swelling in AA rats like TP did, but XFC could improve ultrastructural change of rat's synovicocyte and splenic lymphocyte better than that of TP, which was likely the morphological basis of XFC's therapeutical effect.

Sudden cardiac death in the United States, 1989 to 1998

BACKGROUND

Sudden cardiac death (SCD) is a major clinical and public health problem.

METHODS AND RESULTS

United States (US) vital statistics mortality data from 1989 to 1998 were analyzed. SCD is defined as deaths occurring out of the hospital or in the emergency room or as "dead on arrival" with an underlying cause of death reported as a cardiac disease (ICD-9 code 390 to 398, 402, or 404 to 429). Death rates were calculated for residents of the US aged >/=35 years and standardized to the 2000 US population. Of 719 456 cardiac deaths among adults aged >/=35 years in 1998, 456 076 (63%) were defined as SCD. Among decedents aged 35 to 44 years, 74% of cardiac deaths were SCD. Of all SCDs in 1998, coronary heart disease (ICD-9 codes 410 to 414) was the underlying cause on 62% of death certificates. Death rates for SCD increased with age and were higher in men than women, although there was no difference at age >/=85 years. The black population had higher death rates for SCD than white, American Indian/Alaska Native, or Asian/Pacific Islander populations. The Hispanic population had lower death rates for SCD than the non-Hispanic population. From 1989 to 1998, SCD, as the proportion of all cardiac deaths, increased 12.4% (56.3% to 63.9%), and age-adjusted SCD rates declined 11.7% in men and 5.8% in women. During the same time, age-specific death rates for SCD increased 21% among women aged 35 to 44 years.

CONCLUSIONS

SCD remains an important public health problem in the US. The increase in death rates for SCD among younger women warrants additional investigation.

Hot electrons in the interaction of femtosecond laser pulses with foil targets at a moderate laser intensity

Characteristics of hot electrons produced in the interaction of femtosecond laser pulses with foil targets were investigated at a moderate laser intensity. Both outgoing and ingoing hot electrons from the femtosecond laser plasma were studied. A collimated jet of outgoing hot electrons was observed in the target normal direction. An ingoing energetic hot-electron beam was found in the laser propagation direction, while the low-energy ingoing electrons spread into wider cone angle due to the collisional effects in the plasma and target material. These observations were supported by three-dimensional Monte Carlo simulations. The hot-electron temperature obtained from electron spectra and absorption experiments implies that resonance absorption is partially responsible for the generation of hot electrons.

Prevalence and Correlates of Coronary Calcification in Black and White Young Adults

Abstract —Whereas cardiovascular risk factor levels are substantially different in black and white Americans, the relative rates of cardiovascular disease in the 2 groups are not always consistent with these differences. To compare the prevalence of coronary calcification, an indicator of coronary atherosclerosis, in young adult blacks and whites, we performed electron-beam computed tomography of the heart in 443 men and women aged 28 to 40 years recruited from a population-based cohort. The presence of calcium, defined as at least 1 focus of at least 2.05 mm 2 in area and >130 Hounsfield units in density within the coronary arteries, was identified in 16.1% of black men, 11.8% of black women, 17.1% of white men, and 4.6% of white women ( P =0.04 for comparison across groups). Coronary calcium was associated with age and male sex, and after adjustment for age, race, and sex, coronary calcium was positively associated with body mass index, weight, systolic blood pressure, total cholesterol, low density lipoprotein cholesterol, triglycerides, and fasting insulin and negatively associated with education (all P <0.05). Independent risk factors included male sex, body mass index, and low density lipoprotein cholesterol. Race was not significantly associated with coronary calcium in men or women, before or after adjustment for risk factors. Coronary calcification is associated with increased levels of cardiovascular risk factors in young adults, and its prevalence is not significantly different in blacks and whites.

Apolipoprotein E is a genetic risk factor for fetal iodine deficiency disorder in China

Fetal iodine deficiency disorder (FIDD) is the principal form of endemic cretinism, and the most common cause of preventable mental deficiency in the world. However not everyone at risk develops FIDD and familial aggregation is common. This suggests that genetic factors may also be involved. The Apolipoprotein E (APOE) gene encodes for a lipoprotein that possesses a thyroid hormone binding domain, and APOE genotype may affect the efficiency with which thyroid hormone influences neuronal cell growth during the first and second trimesters of fetal development. We have compared ApoE genotypes in 91 FIDD cases with 154 local control subjects, recruited from three iodine deficiency areas in central China. We have also genotyped 42 FIDD family cases and 158 normal individuals from the families of local controls, and 375 population controls from Shanghai. APOE epsilon4 genotypes were significantly enriched in FIDD probands from each of the three iodine deficiency areas; the epsilon4 allele frequency was 16% vs 6% in controls. The same effect was also observed when we compared FIDD family cases with controls and control families. Our data suggest that in iodine-deficient areas, the APOE epsilon4 allele is a genetic risk factor for FIDD. The phenomenon may affect population selection and contribute to the low frequency of the epsilon4 allele in Chinese compared to Caucasian populations.

Plasma fatty acid composition and 6-year incidence of hypertension in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study

The association of baseline fatty acid composition in plasma cholesterol esters with 6-year incidence of hypertension was examined in middle-aged Minneapolis participants of the Atherosclerosis Risk in Communities (ARIC) Study (1987-1995). Compared with those who were never hypertensive (n = 1,975), incident hypertensives (n = 413) had statistically significantly higher baseline levels of palmitic (16:0) and palmitoleic (16:1n7) acids but lower levels of linoleic (18:2n6) acid and the polyunsaturated/saturated fatty acids ratio (P/S ratio). Among polyunsaturated fatty acids, levels of dihomo-gamma-linolenic (20:3n6) and arachidonic (20:4n6) acids were statistically significantly higher in incident hypertensives, compared with normotensives. After adjustment for age, sex, body mass index, waist/hip ratio, smoking status, ethanol intake, education level, physical activity, and baseline systolic blood pressure in separate models, the odds ratio estimates of incident hypertension for an interquartile increment of a fatty acid in cholesterol esters were 1.26 (95% confidence interval (CI): 1.05, 1.51) for 16:0, 1.11 (95% CI: 0.96, 1.28) for 16:1n7, 1.01 (95% CI: 0.85, 1.21) for 20:3n6, 1.14 (95% CI: 1.03, 1.27) for 20:5n3, 0.81 (95% CI: 0.68, 0.96) for 18:2n6, and 0.83 (95% CI: 0.70, 0.99) for the P/S ratio. The authors conclude that reduced levels of linoleic acid and the P/S ratio and elevated levels of palmitic and arachidonic acids are associated with a higher risk of hypertension.

Associations of ankle-brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) Study

The resting ankle-brachial index (ABI) is a non-invasive method to assess the patency of the lower extremity arterial system and to screen for the presence of peripheral occlusive arterial disease. To determine how the ABI is associated with clinical coronary heart disease (CHD), stroke, preclinical carotid plaque and far wall intimal-medial thickness (IMT) of the carotid and popliteal arteries, we conducted analyses in 15 106 middle-aged adults from the baseline examination (1987-1989) of the Atherosclerosis Risk in Communities (ARIC) Study. The prevalence of clinical CHD, stroke/transient ischemic attack (TIA) and preclinical carotid plaque increased with decreasing ABI levels, particularly at those of < 0.90. Individuals with ABI < 0.90 were twice as likely to have prevalent CHD as those with ABI > 0.90 (age-adjusted odds ratio (OR) ranging from 2.2 (95% CI: 1.0-5.1) in African-American men to 3.3 (95% CI: 2.1-5.0) in white men). Men with ABI < 0.90 were more than four times as likely to have stroke/TIA as those with ABI > 0.90 (age-adjusted OR: 4.2 (95% CI: 1.8-9.5) in African-American men and 4.9 (95% CI: 2.6-9.0) in white men). In women the association was weaker and not statistically significant. Among those free of clinical cardiovascular disease, individuals with ABI < or = 0.90 had statistically significantly higher prevalence of preclinical carotid plaque compared to those with ABI > 0.90 (age-adjusted ORs ranging from 1.5 (95% CI: 1.0-1.9) in white women to 2.6 (95% CI: 1.0-6.6) in african-american men). The ABI was also inversely associated with far wall IMT of the carotid arteries (in both men and women) and the popliteal arteries (in men only). The associations of ABI with clinical CHD, stroke, preclinical carotid plaque and IMT of the carotid and popliteal arteries were attenuated and often not statistically significant after further adjustment for LDL cholesterol, cigarette smoking, hypertension and diabetes. These data demonstrate that low ABI levels, particularly those of < 0.90, are indicative of generalized atherosclerosis.

Short-term and long-term variability of plasma homocysteine measurement

Within-person and methodological variability of a given analyte are important elements in determining whether an individual has altered concentrations of that analyte. We report the short-term (1 month) within-person, between-person, and methodological variability of plasma homocysteine in 20 healthy participants from whom samples were drawn weekly for 4 weeks. The short-term between-person variance was high, whereas within-person and methodological variances were relatively very low, giving a high reliability coefficient (R) for homocysteine (R = 0.94). The long-term (30 months) reliability coefficient was 0.65, but was greatly influenced by an outlier (R = 0.82 with the outlier excluded). The data suggest that an individual's plasma homocysteine concentration is relatively constant over at least 1 month, and a single measurement characterizes the average concentration reasonably well.